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John Davis Dec 4, 2020 a 4:12 pm PST
This is the quote I provided:
“Suffice to say, there is still valid Texas Supreme Court precedent (Albertsons) that requires that the Act(which would include the statutory provisions related to eligibility and entitlement to SIBS) to be liberally construed in favor of awarding benefits to injured workers. Moreover, the Garcia case, which overturned the lower court’s finding that the Texas Workers’ Compensation Act itself was unconstitutional on its face, in part, was eventually found constitutional as it was deemed that it provided an adequate remedy for long term benefits for the most severely injured Texas workers; not so sure that, currently, as applied, that this rationale still applies. We now, currently have a system in place, due to manipulation of rules and lobbying whereby, injured Texas workers, who suffer the misfortune to be so severely injured at work that it requires the fusion of their spine, receive an impairment rating that fails to qualify them to even seek, much less receive long term indemnity benefits (SIBS) to support their families while they continue to convalesce. Quite often the aforereferenced injured workers are forced to turn to the Social Security Disability system for these benefits as their injuries prevent them from being able to work, a price we all pay as taxpayers when it is the workers compensation insurance carriers who should be responsible and accountable for bearing this burden. So the short answer to your question is unequivocally no; the rules are not too generous, in fact, they are not generous enough and not up to par with the constitutional rationale of Garcia. This appears to be just another example of another profit driven insurance carrier seeking to limit the scope of their liability by making it more difficult for the most severely injured Texas workers to receive the benefits they need to support their families after suffering the misfortune of a severe and debilitating injury at work and pass the responsibility on to someone else, often us taxpayers, forcing these severely injured Texas workers to seek benefits administered by and through the Social Security System.”
Moreover, it is our opinion that counselor Kelley’s comment that severely injured workers are improperly receiving assistance in filing applications from their spouse and/or attorneys, if they are fortunate to have counsel, is inapt, ridiculous, erroneous, and hypocritical given that insurance carriers, as a matter of practice, employ lawyers to perform many administrative functions, by rule, that clearly and specifically require the “insurance carrier” to attest or perform (Example: writing so called “analysis letters” to DWC designated doctors.